Dados do Trabalho

Título

Determinants of COVID-19 Incidence and Mortality in Espírito Santo, Brazil

Introdução

COVID-19 emerged in Espírito Santo (ES) in February 2020. Since then, over 1.3 million cases and 15,000 deaths have been recorded. The spread of the disease varies significantly across geographic regions, linked to various ecological, social, and demographic factors.

Objetivo (s)

This study evaluated the effects of sociodemographic variables on the spread and burden of COVID-19 in ES using data from the State Health Department and sociodemographic data for univariate and multivariate statistical analyses.

Material e Métodos

All analyses were performed using R (v4.3.2), with p < 0.05 considered significant.

Resultados e Conclusão

The ES exhibited twelve epidemic COVID-19 waves from 2020 to 2023, associated with the replacement of circulating viral variants. The average case fatality rate (CFR) over the study period was 1.1%, with annual rates of 1.86% in 2020, 2.04% in 2021, 0.23% in 2022, and 0.28% in 2023. Viral transmission was higher in the Vitória metropolitan region during the waves of B.1.1.33/B.1.1.28 (Re = 2.08 vs. 1.91), P.1 (Re = 1.27 vs. 1.23), B.1.617.2 (Re = 1.26 vs. 1.19), and BA.1 (Re = 2.52 vs. 2.30). In contrast, transmission was higher in the inner state during the waves of P.2 (Re = 1.34 vs. 1.15) and BA.5 (Re = 1.88 vs. 1.53). The aging index, median age, municipal Human Development Index, and literacy rate positively correlated with municipal COVID-19 incidence (R^2 ≥ 0.51, p ≤ 0.01). Symptoms such as respiratory difficulty (OR = 4.05), fever (OR = 1.78), and diarrhea (OR = 1.21), and comorbidities including obesity (OR = 3.92), renal disease (OR = 2.34), diabetes (OR = 1.52), cardiovascular disease (OR = 1.50), pulmonary disease (OR = 1.40), and smoking (OR = 1.33) significantly increased the odds of mortality (p ≤ 0.005). Conversely, runny nose (OR = 0.53), sore throat (OR = 0.59), and headache (OR = 0.74) were associated with decreased odds of mortality (p < 0.001). Male sex (OR = 1.53), increasing age (OR = 1.09), and lower educational attainment (OR ≥ 1.44) were associated with increased odds of mortality (p ≤ 0.043). In conclusion, our study highlights the critical role of sociodemographic factors in influencing the spread and impact of COVID-19 in ES. Understanding these determinants can aid in designing targeted interventions and public health strategies to manage and mitigate future outbreaks, particularly in vulnerable populations.    

Palavras Chave

COVID-19; sociodemographic factors; epidemiological analysis; Espírito Santo; viral transmission; case fatality rate